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Case Reports
. 2020 Nov 26;20(1):312.
doi: 10.1186/s12890-020-01352-y.

A case report of aspergillosis accompanied by saccular bronchodilation after bronchial thermoplasty in a 19-year-old woman

Shinji Sasada  1 , Kenshiro Ohmura  2 , Tomoyo Oguri  3   4 , Yutaro Fujimoto  3 , Saori Murata  3 , Yumi Tsuchiya  3 , Kota Ishioka  3 , Saeko Takahashi  3 , Morio Nakamura  3 , Masahiro Kaji  2
Affiliations
Case Reports

A case report of aspergillosis accompanied by saccular bronchodilation after bronchial thermoplasty in a 19-year-old woman

Shinji Sasada et al. BMC Pulm Med. .

Abstract

Background: Fungal infections are rarely reported as a complication of bronchial thermoplasty (BT) in patients without immunosuppressive comorbidity.

Case presentation: A 19-year-old woman college student was admitted to our hospital owing to uncontrolled severe asthma despite using the maximum dose of steroid inhalation. She experienced asthmatic attacks more frequently while cheerleading, which is an extracurricular activity. She received BT because she wanted to continue cheerleading. After the second BT session, she developed more sputum and cough. During the third session, white secretion and saccular bronchodilation appeared in the left lower bronchus. Aspergillus fumigatus was detected in the culture of the bronchial lavage sample, and saccular bronchodilation in the affected bronchus was observed on computed tomography (CT). Five months after the start of oral itraconazole, her subjective symptoms as well as her CT findings improved. Her asthma condition improved enough for the patient to continue cheerleading without exacerbation.

Conclusions: It is necessary to consider the possibility of respiratory tract infections including fungal infections after BT. Detailed observations of the entire bronchus and sample collection for microbial culture are highly recommended.

Keywords: Aspergillosis; Bronchial thermoplasty; Case report; Saccular bronchodilation; Severe asthma.

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Conflict of interest statement

The authors declare that they have no competing interests. This manuscript has not been published and is not under consideration for publication elsewhere. Additionally, all of the authors have approved the contents of this paper and have agreed to the journal´s submission policies.

Figures

Fig. 1
Fig. 1
Chest computed tomography images. a Left lower lobe with thickened bronchial wall before bronchial thermoplasty (BT). b Saccular bronchodilation of left lower bronchus (B9, B10) (arrows) and nodular consolidation (triangle) are seen 3 weeks after BT. c Bronchodilation and consolidation are improved 5 months after the start of oral itraconazole administration
Fig. 2
Fig. 2
Bronchoscopic images. a Bronchial thermoplasty (BT) activation to left B9. b White sputum (arrows) and saccular bronchodilation (triangles) are seen 3 weeks after BT (B)
See this image and copyright information in PMC

Comment in

References

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